Filing a ClaimThe first thing an injured contractor should do is to file a LS 203Employees Notice of Claim.

Foreign Workers need to file claims in the New York Office

All American Contractors should file their claims in their District Office

If they were injured in either Iraq,Kuwait or Afghanistan it shouldbe mailed to the New York officethe Second District.

Office of Workers Compensation Programs

Longshore and Harbor Workers Compensation

Post Office Box 249

New York, New York 10014-0249

Fax (646) 264-3002

There are district offices located in New York, Boston, Baltimore, Norfolk, Jacksonville, New Orleans, Houston, San Francisco, Long Beach, Seattle, and Honolulu.

The Defense Base Act (DBA) adopts the provisions of the Longshore and Harbor Workers' Compensation Act (LHWCA) with but a few exceptions. The insurance requirements for the DBA are identical to those found in the LHWCA.

Section 32(a) of the Longshore Act requires every employer either to secure insurance for the payment of workers' compensation benefits provided under the Act or to be permissibly self-insured. The OWCP is responsible for the authorization of insurance carriers and self-insurance of employers. For a list of the over 700 insurance carriers and self-insured employers currently authorized. Three major insurance carriers are currently providing Defense Base Act insurance coverage. They are ACE-USA, AIG, and CNA.

Section 4(a) of the Act requires every employer to be liable for, and to secure the payment of, disability, medical, and death benefits to its employees in the event of injury or death. If a subcontractor fails to secure the payment of compensation, the contractor will be liable for and be required to secure the payment of such benefits.

Section 5(a) of the Act provides that "a contractor shall be deemed the employer of a subcontractor's employees if the subcontractor fails to secure the payment of compensation."

Section 5(a) also provides that if an employer fails to secure payment of compensation as required by this Act, an injured employee, or his survivors in case death results from the injury, may elect to sue the employer for tort damages on account of such injury or death. In such action the defendant may not plead as a defense that the injury was caused by the negligence of a fellow servant, or that the employee assumed the risk of his employment, or that the injury was due to the contributory negligence of the employee.

Section 38(a) provides that an employer who fails to secure the payment of compensation when required shall be guilty of a misdemeanor and, upon conviction thereof, shall be punished by a fine of not more than $10,000 or by imprisonment for not more than one year, or both. And if the employer is a corporation, the president, secretary, and treasurer shall be also severally liable for such fine and imprisonment.

Furthermore, if a corporation fails to secure the payment of compensation, the president, secretary, and treasurer shall be severally and personally liable, jointly with the corporation, for any compensation or other benefits payable under the Act in respect to any injury or death which may occur to any of its employees.

§ 61.100 The Office shall reimburse any carrier that pays benefits under the Defense Base Act or other applicable workers' compensation law due to the injury, disability or death of any person specified in §61.1(a), if the injury or death for which the benefits are paid arose from a war-risk hazard. The amount to be reimbursed includes disability and death payments, funeral and burial expenses, medical expenses, and the reasonable and necessary claims expense incurred in processing the request.

(b) The Office shall not provide reimbursement in any case in which an additional premium for war-risk hazard was charged, or in which the carrier has been reimbursed, paid, or compensated for the loss for which reimbursement is requested.

(c) Reimbursement under this section with respect to benefits shall be limited to the amounts which will discharge the liability of the carrier under the applicable workers' compensation law.

§ 61.104 Reimbursement of claims expense.(to Insurancecarrier)top(a) A carrier may claim reimbursement for reasonable and necessary claims expense incurred in connection with a case for which reimbursement is claimed under the Act. Reimbursement may be claimed for allocated and unallocated claims expense.

(b) The term “allocated claims expense” includes payments made for reasonable attorneys' fees, court and litigation costs, expenses of witnesses and expert testimony, examinations, autopsies and other items of expense that were reasonably incurred in determining liability under the Defense Base Act or other workers' compensation law. Allocated claims expense must be itemized and documented as described in §61.101.

(c) The term “unallocated claims expense” means costs that are incurred in processing a claim, but cannot be specifically itemized or documented. A carrier may receive reimbursement of unallocated claims expense in an amount of to 15% of the sum of the reimbursable payments made under the Defense Base Act or other workers' compensation law. If this method of computing unallocated claims expense would not result in reimbursement of reasonable and necessary claims expense, the Office may, in its discretion, determine an amount that fairly represents the expenses incurred.

(d) The Office shall not consider as a claims expense any general administrative costs, general office maintenance costs, rent, insurance, taxes, or other similar general expenses. Nor shall expenses incurred in establishing or documenting entitlement to reimbursement under the Act be considered.

The issuance of an authorization for treatment by the employer shall bind his insurance carrier to furnish and pay for such care and services.

Sec. 702.203 Employer's report; how given.The employer's report, an original and one copy, may be furnished by delivering it to the appropriate office of the district director, or by mailing it to said office.

Sec. 702.392 Appeals; what may be appealed.An appeal raising a substantial question of law or fact may be taken from a decision with respect to a claim under the Act. Such appeals may be taken from compensation orders when they have been filed as provided for in Sec. 702.349.

Sec. 702.403 Employee's right to choose physician; limitations.The employee shall have the right to choose his/her attending physician from among those authorized by the Director,(any doctor that is not on the NO Doctors List, you can choose and Department of Labor states there are none in Spring of 08 see below) OWCP, to furnish such care and treatment, except those physicians included on the Secretary's list of debarred physicians. In determining the choice of a physician, consideration must be given to availability, the employee's condition and the method and means of transportation. Generally 25 miles from the place of injury, or the employee's home is a reasonable distance to travel, but other pertinent factors must also be taken into consideration.IE....NO specialist for Injury within a reasonable range, then you go to next city closest to the INJURED!, NOT Flying to Texas for a MMPI-2 test/ Fake Bad Scale) to see the insurance company hired doctor, That IS NOT Reasonable nor justified for reimbursement. Second opinions come from the Court not Insurer....(see Sec. 702.135 for mileage fees paid...)

Sec. 702.404 Physician defined.The term physician includes doctors of medicine (MD), surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law. The term includes chiropractors only to the extent that their reimbursable services are limited to treatmentconsisting of manual manipulation of the spine to correct a subluxation shown by X-ray or clinical findings. Physicians defined in this part may interpret their own X-rays. All physicians in these categories are authorized by the Director to render medical care under the Act. Naturopaths, faith healers, and other practitioners of the healing arts which are not listed herein are not included within the term "physician'' as used in this part.

Sec. 702.135 Payment of claimant's witness fees and mileage in disputed claims.In cases where an attorney's fee is awarded against an employer or carrier there may be further assessed against such employer or carrier as costs, fees and mileage for necessary witnesses attending the hearing at the instance of claimant. Both the necessity for the witness and the reasonableness of the fees of expert witnesses must be approved by the hearing officer, the Board, or the court, as the case may be. The amounts awarded against an employer or carrier as attorney's fees, costs, fees and mileage for witnesses shall not in any respect affect or diminish the compensation payable under this Act (see Act, section 28 (d)). Subpart D_Medical Care and Supervision-Revised April 08

Sec. 702.408 Evaluation of medical questions; impartial specialists.In any case in which medical questions arise with respect to the appropriate diagnosis, extent, effect of, appropriate treatment, and the duration [[Page 907]] of any such care or treatment, for an injury covered by the Act, the Director, OWCP, through the district directors having jurisdiction, shall have the power to evaluate such questions by appointing one or more especially qualified physicians to examine the employee, or in the case of death to make such inquiry as may be appropriate to the facts and circumstances of the case. The physician or physicians, including appropriate consultants, should report their findings with respect to the questions raised as expeditiously as possible. Upon receipt of such report, action appropriate therewith shall be taken.*** Subpart B_Claims Procedures

Sec. 702.204 Employer's report; penalty for failure to furnish and or falsifying.Any employer, insurance carrier, or self-insured employer who knowingly and willfully fails or refuses to send any report required by Sec. 702.201, or who knowingly or willfully makes a false statement or misrepresentation in any report, shall be subject to a civil penalty not to exceed $10,000.00 for each such failure, refusal, false statement, or misrepresentation. Provided, however, that for any violations occurring on or after November 17, 1997 the maximum civil penalty may not exceed $11,000.00. The district director has the authority and responsibility for assessing a civil penalty under this section.

Sec. 702.603 Determining the payrate for compensating occupational disease claims which become manifest after retirement.(a) If the time of injury occurs within the first year after the employee has retired, the payrate for compensation purposes shall be one fifty-second part [[Page 917]]of the employee's average annual earnings during the fifty-two week period preceding retirement.(b) If the time of injury occurs more than one year after the employee has retired the payrate for compensation purposes shall be the national average weekly wage, determined according to section 6(b)(3) of the Act, 33 U.S.C. 906(b)(3), at the time of injury.***********************************************

If you have "MULTIPLE INJURIES" you are not expected to become your own doctor and diagnose your injuries. Facts...

The Likely hood of a contractors coming home with ONLY 1 injury is pretty rare, and in many cases, require several different doctors.

If your first doctor doesn't specialize in that injury, then you have a right to choose another FIRST CHOICE DOCTOR FOR the other INJURIES (specialist's), not the insurance company.Unless you just want to change doctors, then you must get approval. Other words, you get a First choice doctor per injury. NOT JUST THE ONE INJURY

Attorney's who represent the injured (Claimants) under the DBA must FIGHT for all your compensation needs. These attorney's are not doctors and can not choose what they think you should or will get. They are required by law to Represent your rights to ALL Compensation that you are entitled to under the DBA...(PTSD & Diseases INCLUDED!)See Iraq Infections at: www.IraqInfections.com for more information on this.

If you find a DBA attorney who refuses to take your CASE or will tell you that only one injury is worth fighting for, then let us know! EXAMPLE: Your injured in Iraq, your sent home and you go to your family physician, he tells you that you need to see a Brain Injury Doctor and an Orthopedic surgeon. The insurance has to pay for that doctor, on top YOU get to choose your first choice neurologist AND your Orthopedic surgeon! Again NOT THE INSURANCE Company, you don't have to go to who they tell you to unless you just want to...

DBA insurance premiums are based on a percentage of your full pay, taxable pay to include all incentives and up pays.

The US Government reimburses the DBA insurance company for all claims and expenses that qualify for War Hazard Recovery under the War Hazards Act.

FECA BULLETIN NO. 12-01

XI. Miscellaneous

1. DFEC requires, before acceptance of any WHCA reimbursement claim, that the employer/carrier hasmade only reasonable and prudent efforts in presenting all meritorious defenses against a DBA claimwithout regard to whether the case is eligible for WHCA reimbursement. An employer/carrier’s inadequateor overly zealous representation in defending against a DBA claim may be grounds for denying all or someportion of a request for WHCA reimbursement.

CECILY A. RAYBURNDirector, Division of Planning, Policy and Standards

As a DBA Claimant you'll be pleased to learn that

THERE IS NO PAIN AND SUFFERINGUNDER THE DEFENSE BASE ACT

The Defense Base ActThe Government MandatedTaxpayer SupportedLICENSE TO KILL